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Part 8.OPERATOR INFORMATION(For diol site,if operator is different from land owner,attach leather agreement) <br /> TYPE OF BUSINESS: <br /> OSOLE PROPRIETORSHIP PARTNERSHIP CORPORATION El GOVERNMENT AGENCY <br /> FACILITY OPERATOR(S) SSN OR TAX ID#: <br /> (Name): <br /> San Joaquin County Department of Public Works Solid Waste Division 6800-14563 <br /> ADDRESS,CITY,STATE,ZIP <br /> TELEPHONE#: <br /> 1810 E Hazelton Avenue, Stockton CA 95201 209-468-3066 <br /> FAX#: <br /> 209-468-3078 <br /> E-MAIL ADDRESS: <br /> tbahadori(@-sigov.org <br /> CONTACT PERSON(Print Name): <br /> Ta' Bahadori <br /> Part 9.SIGNATURE BLOCK <br /> Owner: <br /> I certify under penalty of perjury that the information I provided for this application and for any attachments is true and accurate to the best of my knowledge and belief. I <br /> am aware that the operator intends operate a solid waste facility at the site specified above pursuant to this application and understand that I may be responsible for <br /> the site should the op fail t eet applicable requirements. <br /> SIGNATURE(LAND OWNER OR AGENT): <br /> PRINTED NAME: Desi Reno <br /> TITLE: Integrated Waste Manager DATE: <br /> Operator: <br /> I certify under penalty ury that the information contained in this application and all attachments are true and accurate to the best of my knowledge and belief. <br /> SIGNATURE(FACILITY OPERATOR OR AGENT): <br /> PRINTED NAME: Desi Reno <br /> ICliol a,.,' <br /> TITLE: Integrated Waste Manager D E: <br /> Part 10.OTHER (Attach additional sheets to explain any responses that need clarification). <br /> Lovelace Permit Modification 2015 Printed 10/20/2015 <br />